Substrate of complex fractionated atrial electrograms: evidence by pathologic analysis

作者：You De-jun; Chang Dong; Zhang Shu-long^*; Yang Dong-hui; Gao Lian-jun; Yin Xiao-meng; Chu Zhen-liang; Xia Yun-long; Wang Yu-chun; Dong Ying-xue; Yang Yan-zong

来源：Chinese Medical Journal, 2012, 125(24): 4393-4397.

DOI：10.3760/cma.j.issn.0366-6999.2012.24.013

• complex fractionated atrial electrograms
• atrial fibrillation
• pathologic examination
• ganglionated plexus

Background Ablation of complex fractionated atrial electrograms (CFAE) is an important adjunctive therapy in atrial fibrillation (AF). The present study was to elucidate the substrate underlying CFAE. @@@ Methods Nine adult mongrel dogs were involved in the present study. AF was induced through rapid atrial pacing with vagosympathetic nerve stimulation. CFAE was recorded during AF. Ablation was performed at CFAE sites. Based on the location of the ablation scar, the atrial specimens were divided into CFAE and non-CFAE sites. Serial sections of the atrium were stained respectively with hematoxylin-eosin (HE) and the general neural marker protein gene product 9.5 (PGP9.5). We compared the characteristics of the myocardium and the ganglionated plexus (GPs) distribution between the CFAE and non-CFAE sites. @@@ Results The myocardium of non-CFAE sites was well-organized with little intercellular substance. However, the myocardium in the CFAE site was disorganized with more interstitial tissue ((61.7 +/- 24.3)% vs. (34.1 +/- 9.2)%, P <0.01). GPs in the CFAE site were more abundant than in non-CFAE sites ((34.45 +/- 37.46) bundles/cm(2) vs. (6.73 +/- 8.22) bundles/cm(2), P <0.01). @@@ Conclusion The heterogeneity of the myocardium and GPs distribution may account for the substrate of CFAE and serve as a potential target of ablation. Chin Med J 2012;125(24):4393-4397

• 出版日期2012-12-20
• 单位吉林大学; 大连医科大学